Overview: Two Ways to Pay for NEMT
When you need non-emergency medical transportation in Chicago, you have two primary payment options: private pay (out-of-pocket) and Medicaid coverage. Both are legitimate, widely used, and appropriate in different situations. This comparison is designed to give you an honest, unbiased look at both so you can make the best decision for your circumstances.
Dream Care Rides is a private-pay-first NEMT provider that also accepts Medicaid in select service areas. We serve private-pay patients directly with no broker intermediary. Medicaid accepted in select service areas — call (708) 505-6994 to check availability. Our goal is to provide the best possible service regardless of how you pay — but the two payment paths do differ in meaningful ways that affect your experience.
The key differences come down to cost, flexibility, booking lead time, driver consistency, and vehicle choice. The table below breaks down each factor side by side. For additional context, see the Illinois Department of Healthcare and Family Services Medicaid page and our private pay information page.
Side-by-Side Comparison
| Feature | Private Pay | Medicaid |
|---|---|---|
| Out-of-pocket cost | $30–$60 (ambulatory) to $350–$400 (stretcher) base per leg, plus mileage | $0 for eligible beneficiaries |
| Booking lead time | 24-48 hours (same-day possible) | 48-72 hours minimum |
| Who assigns the provider? | You choose your provider | MCO broker assigns provider |
| Vehicle choice | You select vehicle type | Assigned based on medical need |
| Driver consistency | Assigned driver via standing order | May vary per trip |
| Schedule flexibility | Reschedule free online up to 2 hours before pickup | Limited changes, broker dependent |
| Same-day booking | Often available | Rarely available |
| Will-call returns | Always available | Some brokers support, others do not |
| Standing orders | Yes, with up to 15% discount | Available through MCO |
| Companion rider | Always free | Usually allowed, varies by MCO |
| Eligibility | Anyone, no requirements | Must be enrolled in Illinois Medicaid |
| Payment method | Credit card, debit, ACH | No payment — billed to MCO |
| Service hours | 24/7 including holidays | Varies by broker and provider network |
When Private Pay Makes Sense
Private pay is the best choice when flexibility, speed, and consistency matter most. Specific situations where private pay excels include the following.
Hospital discharges — unpredictable timing requires flexible scheduling that brokers cannot always accommodate.
Urgent appointments — same-day or next-day bookings when the 48-72 hour Medicaid window is too slow.
Recurring treatments — dialysis, chemotherapy, or PT where a consistent assigned driver improves the patient experience.
No Medicaid eligibility — patients who do not qualify for Medicaid but need professional medical transport.
Premium service — patients who want to choose their provider, vehicle type, and driver rather than accept broker assignments.
Long-distance trips — cross-county or interstate medical transport that some Medicaid brokers do not cover.
When Medicaid Makes Sense
Medicaid NEMT is an essential benefit for eligible beneficiaries. It eliminates the financial barrier to medical care by covering transportation at no out-of-pocket cost. Medicaid works best in these situations.
Financial hardship — patients who cannot afford out-of-pocket NEMT costs, especially for recurring rides.
Predictable schedules — appointments booked well in advance where the 48-72 hour window is not a problem.
Routine appointments — standard doctor visits, lab work, and follow-ups that fit within broker scheduling timelines.
Ongoing treatments — dialysis, physical therapy, and other recurring appointments that can be set up as standing orders through the MCO.
Budget constraints — families managing multiple medical appointments for a loved one where cumulative costs would be prohibitive.
Learn more about Medicaid coverage for NEMT in our Medicaid NEMT coverage guide or check eligibility through the Illinois ABE portal.
Book Your Medical Ride — Private Pay or Medicaid
Dream Care Rides accepts both. Call us to discuss which option works best for your situation.
The Hybrid Approach: Using Both
Many of our patients use a combination of Medicaid and private pay to get the best of both worlds. This hybrid approach is completely legitimate and is in fact the optimal strategy for many situations. For example, a dialysis patient might use Medicaid for their 3x/week standing-order rides (predictable, booked in advance, zero cost) and switch to private pay when they need an unexpected hospital discharge ride or an urgent appointment that falls within the 48-hour Medicaid booking window.
Another common pattern: families use Medicaid for routine medical visits and pay privately for the rides where driver consistency and scheduling flexibility matter most, such as chemotherapy sessions where the patient has a strong preference for a familiar, trusted driver.
Dream Care Rides can help you develop a hybrid plan that minimizes costs while maximizing the quality and reliability of your medical transportation. Call (708) 505-6994 to discuss your options with a dispatcher who understands both payment systems.
Otse Amorighoye
Founder & CEO, Dream Care Rides
Otse Amorighoye founded Dream Care Rides to make medical transportation accessible to every patient. His company serves private pay patients across the Chicago metro area, and accepts Medicaid in select service areas.
Frequently Asked Questions
Neither is universally better — each serves different needs. Private pay offers maximum flexibility: shorter booking windows, vehicle choice, consistent driver assignment, and no third-party broker. Medicaid NEMT provides no-cost rides for eligible beneficiaries, making it essential for patients who cannot afford out-of-pocket transportation. Many patients use a hybrid approach — Medicaid for recurring rides and private pay for urgent or time-sensitive trips.
Medicaid NEMT has zero out-of-pocket cost for eligible beneficiaries. Private pay ranges from $30–$60 base for ambulatory service to $350–$400 base for stretcher transport, plus mileage. Base rates are per one-way leg; a round trip is two legs. While private pay has direct costs, it offers significant advantages in scheduling speed, driver consistency, and overall service quality. Patients who value flexibility and reliability often find private pay worth the investment.
Yes, many patients use a hybrid approach. They use Medicaid for recurring rides like dialysis (where the 48-72 hour advance booking requirement aligns with their predictable schedule) and switch to private pay for hospital discharges, urgent appointments, or situations where scheduling flexibility is important. Dream Care Rides accepts both payment methods and can help you optimize your approach.
Medicaid NEMT is coordinated through managed care organizations and their transportation brokers. The 48-72 hour requirement allows the broker to find an available credentialed provider, assign a vehicle, and process the authorization. This multi-step process takes time but ensures the ride is covered under your Medicaid benefits at no cost. Private pay eliminates this intermediary, allowing faster booking.
Medicaid rides are assigned by the MCO's transportation broker, who distributes trips across their network of providers. While Dream Care Rides maintains driver consistency for our standing-order clients, the broker may assign different providers for different trips. Private-pay standing orders guarantee a consistent assigned driver for every ride, which many patients — especially dialysis and cancer treatment patients — find highly valuable.
To qualify for Medicaid NEMT in Illinois, you must be enrolled in an Illinois Medicaid managed care plan and need transportation to a Medicaid-covered medical appointment. Eligibility is based on income and household size. Contact the Illinois Department of Healthcare and Family Services or your MCO (Meridian, Molina, Blue Cross Community, etc.) to verify your eligibility and learn how to request rides through their transportation benefit.
Related Pages
Last updated: March 23, 2026. This comparison is reviewed and updated quarterly.